The journal of trauma and acute care surgery
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The increased morbidity and mortality associated with coagulopathy and thrombocytopenia after trauma are well described. However, few studies have assessed platelet function after injury. ⋯ In this prognostic study, we identify clinically significant platelet dysfunction after trauma in the presence of an otherwise reassuring platelet count and standard clotting studies, with profound implications for mortality. Multiple electrode impedance aggregometry reliably identifies this dysfunction in injured patients, and admission AA and collagen responsiveness are sensitive and specific independent predictors of both early and late mortality.
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J Trauma Acute Care Surg · Jul 2012
Clinical TrialIntensive exercise after thermal injury improves physical, functional, and psychological outcomes.
Although exercise programs after burns are considered a standard of care, there is limited evidence for efficacy in adult patients. This study aimed to investigate the effects of an exercise program on physical, functional, and quality of life measures. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jul 2012
Does the size of the hemoperitoneum help to discriminate the bleeding source and guide therapeutic decisions in blunt trauma patients with pelvic ring fracture?
In blunt trauma patients with a hemoperitoneum and a pelvic injury, multiple sources of active bleeding may exist. The purpose of this study was to determine whether the size of the hemoperitoneum helps to establish the bleeding source and guide therapeutic decisions in patients with pelvic fractures. ⋯ In patients with pelvic fractures, hemoperitoneum does not mean peritoneal injury requiring hemostatic procedure. Semiquantitative analysis of the hemoperitoneum improves predictability of peritoneal hemorrhage than qualitative analysis of hemoperitoneum. However, there remains numerous false-positives even in presence of large hemoperitoneum associated with hypotension.
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J Trauma Acute Care Surg · Jul 2012
Patterns of pediatric injury in South Africa: an analysis of hospital data between 1997 and 2006.
Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Despite the magnitude of this burden, there is lack of data to characterize the etiology and risk factors associated with childhood injuries, especially in low- and middle-income countries. The aim of this article is to describe the demographics, mechanisms, and severity of injuries during a 10-year time period using hospital-based data in Cape Town, South Africa. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jul 2012
Validation of the pulse rate over pressure evaluation index as a detector of early occult hemorrhage: a prospective observational study.
The aim of this study was to validate a calculation of pulse rate (PR) divided by pulse pressure (pulse rate over pressure evaluation [ROPE] index) as a method of predicting early hemorrhagic compensation in healthy patients donating blood. The ROPE index calculations were compared with shock index (PR divided by systolic blood pressure) calculations for the same donors. ⋯ Prognostic study, level II.